Cataract with clinical Case Presentation

Cataract along with case Presentation .

1. CLINICAL CASE PRESENTATION (cataract ) Name : Souvik Chowdhury Course : Master Of Optometry ( 1st Yr ) College - INSTITUTE OF MANAGEMENT STUDY

2. Patient Details Name : kanailal Senapati Age : 68 yrs. Sex : Male Address : Debpukur , Barrackpore Occupation : Retired perso n

3. Chief of Complaints Dimness of vision in his both eyes at distance and near . He feels Much more problem to see in his Left eye than right . Sudden much more vision problem from 1 month ago . Facing photophobia problem specially at night . Itching and watering occassionally in his Both eyes . History No history of Prolonged illness . No family history of glaucoma . Patient has hypertension and Diabetes since 10 yrs .

4. Clinical Examination : Vision check up : Right Eye Left Eye UCVA FC 2ft 6/60 With Pinhole 4/60 6/18P Near vision <N/36 N/36 Ocular movemnt : Full IOP (NCT) : 19 mmhg 18 mmhg Subjective Refrcation : RE : Plano - Fc 2ft LE : - 2.00 Dsph - 6/18P ADD BE : +2.50 < N36 N12 Retinoscopy : - 1.00 No Glow -1.50 Poor Glow -

5. Anterior Segment Examination By Slit Lamp RE LE Lids Normal Normal Conjuctiva Ciliary Congestion Ciliary Congestion Cornea Clear Clear Pupil Round Regular Reactive Round RegularReactive Anterior Chamber Deep Deep Lens NS IV NS III

6. Posterior Segment Examination RE : was not visible LE : C:D ratio - 0.4 Macula - poorly visibile Vessels - seen normal Doctor Advice : Suggestion for Cataract surgery by phacoemulsification procedure for his Right Eye as early as possible . Ask to Patient will come for pre operative check Up with his current PPBS , FBS , ECG and HB% report. Also advice to patient for Some Preoperative Test e.g . Biometry & syringing Test and OCT (RE).

7. Preoperative Check Up Biometry : Syringing : ( BE = patent ) OCT ( RE ) : Mild ERM RE LE K 1 43.50 42.75 K2 44 .00 43.50 Axial length 24.08 mm 25.23 mm AC depth Avg. 3.54 3.06 IOL + 21.50 D + 19.50 D

8. Systemic Reports PPBS : 149 mg/dl FBS : 100 mg/dl HB% : 11.05 ECG : Normal Blood pressure : 110 /80 mmhg Pulse Rates : 81 beats Body Tempareture : 98 F Councelling : Operation date was fixed and advice to patient 0.5% moxifloxacin eye drops will start to put in his RE in 4 times per day before 5 days ago from his operation date and 0.5 % tropicamide opthalmic solution put in his RE on the operation day morning in 30 mints time interval .

9. Post Operative management Patient asked to lie quietly upon the back for 1-2 hours . Steroid eye drop ( 1% prednisolone acetate opthalmic suspension ) used two hourly for 7 days , after 7 days 4times and then respectively 2times and one times in RE . Moxifloxacin eye drop 6times in RE for 1 month tear substitute eye drop ( sodium Hyluronate 0.1% ) used 4 times daily for 1 month . Give advice to clear shield Follow UP Next day vision check up : RE - 6/12p with pinhole 6/9 LE - 6/60 with pinhole 6/18p IOP ( NCT ) : RE - 17 mmhg LE : 19 mmhg Slit lamp Examination : Cornea - clear AC - deep , Pupil - Round Regular reactive PCIOL - centred and in the Bag

10. Post operative Follow up ( after 1 week ) Vision Check up : RE : 6/12 with pinhole 6/6p LE : 6/60 with pinhole 6/18p IOP ( NCT ) : RE - 16mmhg LE : 18 mmhg Refraction : RE : -0.75 dcyl *80 degree -- 6/6P LE : - 1.50 dsph / -0.50 dcyl *90 degree -- 6/18p Add BE : + 2.50 dsph < N/6 N/12 Slit Lamp Examination : Cornea - clear Ac -deep , cornea - clear , Pupil -- Round Rapid Reacting Fundus -- Normal Advice : Use Glass same medication as per previously guide. normal life . Review after 3 months .

11. Discussion A cataract is a disease that causes the eye's normally clear lens to become cloudy, which can obstruct light from passing through and focusing on the retina. Cataracts are a leading cause of blindness globally and are most common in people over 40, though other factors can also contribute . Cataracts are progressive and can eventually lead to blurry, misty vision and blindness. Treatment depends on the stage of the cataract, the patient's age, and other symptoms. Diagnosis is usually made using a torch light examination and slit lamp evaluation of the pupils

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